title: Acinetobacter baumannii ventilator-associated pneumonia: epidemiology, clinical characteristics, and prognosis factors.
abstract: OBJECTIVE
  The aim of this study was to describe the epidemiological characteristics of Acinetobacter baumannii ventilator-associated pneumonia (VAP) and to identify factors predictive of a poor outcome.
  
  
  METHODS
  A retrospective study was conducted over 16 months in a Tunisian intensive care unit (ICU). All adult patients with A. baumannii VAP were included.
  
  
  RESULTS
  Ninety-two patients were included in they study; 41 (44.6%) were admitted because of multiple trauma. The mean age of the patients was 44.5±19.5 years. All patients needed mechanical ventilation on admission. The mean SAPS II score was 39±15. The mean delay before VAP onset was 8.1±4.7 days. On VAP onset, 57 patients (62%) developed septic shock. Only 14.2% of isolated strains were susceptible to imipenem; none were resistant to colistin. The mean duration of mechanical ventilation was 20±11 days. The mean duration of ICU stay was 24.3±18.7 days. ICU mortality was 60.9%. In the multivariate analysis, factors predictive of a poor outcome were previously known hypertension (odds ratio 5.8, 95% confidence interval 1.4-24.9; p=0.018) and VAP-related septic shock (odds ratio 8.5, 95% confidence interval 3-23.7; p<0.001).
  
  
  CONCLUSIONS
  A. baumannii VAP is associated with a high mortality. Hemodynamic impairment is predictive of a poor outcome.
authors.affiliation: Intensive Care Unit, Faculty of Medicine, University of Sfax, Hôpital Habib Bourguiba, Route el Ain Km 1, 3029 Sfax, Tunisia. Electronic address: anischaari2004@yahoo.fr.
authors.forename: Anis
authors.initials: A
authors.lastname: Chaari
authors.forename: Basma
authors.initials: B
authors.lastname: Mnif
authors.forename: Mabrouk
authors.initials: M
authors.lastname: Bahloul
authors.forename: Fouzia
authors.initials: F
authors.lastname: Mahjoubi
authors.forename: Kamilia
authors.initials: K
authors.lastname: Chtara
authors.forename: Olfa
authors.initials: O
authors.lastname: Turki
authors.forename: Nourhene
authors.initials: N
authors.lastname: Gharbi
authors.forename: Hedi
authors.initials: H
authors.lastname: Chelly
authors.forename: Adnene
authors.initials: A
authors.lastname: Hammami
authors.forename: Mounir
authors.initials: M
authors.lastname: Bouaziz
mesh_terms: D000151:Acinetobacter Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D040981:Acinetobacter baumannii / Q000187:drug effects / Q000302:isolation & purification*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016017:Odds Ratio; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014416:Tunisia / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acinetobacter baumannii; Epidemiology; Prognosis; Ventilator-associated pneumonia